Objective To investigate the distribution of Streptococcus,sensitivity to commonly used antibiotics,and prognosis of the patients with bloodstream infections,and provide evidence for early diagnosis and selection of antibiotics.Methods The Streptococci i-solated from the blood samples of the First Affiliated Hospital of Nanjing Medical University from 2017 to 2022 were collected and di-vided into α-and β-hemolytic Streptococci according to the type of hemolysis.Their sensitivity to commonly used antibiotics was ana-lyzed.The differences in clinical data and prognosis between the two groups were also compared.Results A total of 314 strains of Streptococcus were isolated from 305 patients,including 270 strains of α-hemolytic Streptococcus and 44 β-hemolytic Streptococcus.The results of the drug sensitivity test showed that the proportion of Streptococcus strains with a diameter of 17-19 mm in the inhibition zone of vancomycin increased year by year.The positive alarm time of blood culture for β-hemolytic Streptococcus was significantly shorter than that for α-hemolytic Streptococcus(P＜0.001).Using 10.5 hours as the diagnostic threshold could assist in distinguishing blood-stream infections caused by α-and β-hemolytic Streptococcus.The overall mortality rate of patients with streptococcal bloodstream infec-tion was 15.1％,and there was no statistically significant difference in the mortality rate between the two groups(P=0.813).Conclu-sion The main Streptococcus causing bloodstream infections in our hospital is α-hemolytic Streptococcus.There are differences in the antimicrobial sensitivity and clinical characteristics among patients with different streptococcal bloodstream infections.The positive a-larm time of blood culture can assist in distinguishing the type of streptococcal bloodstream infections.In addition,the diameter of the inhibition zone of vancomycin against Streptococcus has drifted towards the breakpoint of drug resistance.

Objective To investigate the distribution of Streptococcus,sensitivity to commonly used antibiotics,and prognosis of the patients with bloodstream infections,and provide evidence for early diagnosis and selection of antibiotics.Methods The Streptococci i-solated from the blood samples of the First Affiliated Hospital of Nanjing Medical University from 2017 to 2022 were collected and di-vided into α-and β-hemolytic Streptococci according to the type of hemolysis.Their sensitivity to commonly used antibiotics was ana-lyzed.The differences in clinical data and prognosis between the two groups were also compared.Results A total of 314 strains of Streptococcus were isolated from 305 patients,including 270 strains of α-hemolytic Streptococcus and 44 β-hemolytic Streptococcus.The results of the drug sensitivity test showed that the proportion of Streptococcus strains with a diameter of 17-19 mm in the inhibition zone of vancomycin increased year by year.The positive alarm time of blood culture for β-hemolytic Streptococcus was significantly shorter than that for α-hemolytic Streptococcus(P＜0.001).Using 10.5 hours as the diagnostic threshold could assist in distinguishing blood-stream infections caused by α-and β-hemolytic Streptococcus.The overall mortality rate of patients with streptococcal bloodstream infec-tion was 15.1％,and there was no statistically significant difference in the mortality rate between the two groups(P=0.813).Conclu-sion The main Streptococcus causing bloodstream infections in our hospital is α-hemolytic Streptococcus.There are differences in the antimicrobial sensitivity and clinical characteristics among patients with different streptococcal bloodstream infections.The positive a-larm time of blood culture can assist in distinguishing the type of streptococcal bloodstream infections.In addition,the diameter of the inhibition zone of vancomycin against Streptococcus has drifted towards the breakpoint of drug resistance.

Background: Dietary fiber is strongly recommended as the basic treatment for functional constipation according to global guidelines. However, a complete evaluation standard for the laxative functional food remains to be improved in China. Aims: To evaluate the efficacy and safety of the laxative function of a compound fructose-oligosaccharide fiber granule, so as to provide evidence-based medical basis for the evaluation of laxative functional food. Methods: In a randomized, double-blind, parallel and controlled trial with placebo as control, 120 subjects with functional constipation were enrolled in 2 clinical research centers in Beijing, and randomly divided into experimental group and control group (60 cases in each group). Subjects in experimental group were given a compound fructose-oligosaccharide fiber granule dissolved in 50 mL water orally, 1 bag (9 g) per day for 2 weeks; while those in control group were given a placebo granule with the same appearance, specification and dosage as the experimental group. The bowel movement frequency per week, defecation status and stool consistency were recorded before and after the test, and the safety tests were completed. Results: After 2 weeks of treatment, the bowel movement frequency in experimental group increased by (1.63±1.57) times per week, the stool consistency assessed by Bristol stool form scale and the difficulty in defecation were also improved as compared with the baseline (all P<0.05). Furthermore, improvements in experimental group were superior to those in control group (all P<0.05). No allergic and other adverse events were reported during the test, and there were no significant changes in blood, urine, stool routine and blood biochemical indices before and after the test. Conclusions: The compound fructose-oligosaccharide fiber granule tested in this study is proved to have laxative effect and is safety for functional constipation. The testing program is scientific and of feasibility, and may provide a methodology basis for human oral administration trials of laxative functional food.

Objective:To understand the molecular evolutionary and genetic differences of South-East Asian dodeca RNA viruses (Seadornavirus).Methods:The homology, phylogeny, physicochemical properties, epitope prediction, tertiary structure and surface charge distribution were analyzed based on genome sequence of Seadornavirus capsid proteins.Results:The time of most recent common ancestor (tMRCA) of Seadornavirus was estimated to be about 2 359 years ago, which were divided into three clusters. Their tMRCA were about 1 338, 499 and 253 years ago, respectively. And their mean substitution rate of Seadornavirus was 3.6×10 -4 n/s/y. The homology of nucleotide and amino acid was 31.3%-100% (μ=68.0%) and 11.9%-100% (μ=56.0%) respectively. Physicochemical properties and epitope analysis showed that the Banna virus (BAV) capsid protein is an acidic hydrophobic protein that there are 6 B cell epitopes and 2 Th epitopes, while Liaoning virus (LNV) and Kadipiro virus (KDV) are alkaline hydrophilic protein that there are 3 and 5 B cell epitopes, respectively. And there is only 1 Th epitope in the capsid protein of LNV, while KDV does not contain this epitope. The tertiary structure and protein surface charge analysis showed that the alpha helices and beta folds of Seadornavirus were different and the BAV contains two distinctly positively charged regions and two negatively charged regions, LNV has only one positively charged region, and KDV has two positively charged regions. Conclusions:Seadornaviruses had more rapid evolution and strong adaptability, and the genome sequences, protein epitopes, physicochemical properties and the tertiary structures between Seadornaviruses are different.

As an important part of the hierarchical medical system in China ,urban secondary hospitals play as a pivot between tertiary hospitals and community healthcare centers.By describing the overall development status of such hospitals in China ,the paper discussed the problems existing in the development of urban secondary hospitals and put forward strategies in the hope of providing reference for the transformation of these hospitals .

Objective To investigate the value of hysteroscopy in the diagnosis of postmenopausal uterine bleeding.Methods 106 cases of outpatient of postmenopausal bleeding were analyzed.Hysteroscopic diagnosis and the biopsy result were compared in all patients.Results Histological diagnosis was 73 cases of uterine cavity abnormality,33 cases of normal were diagnosed in hysteroscopy.78 cases of pathological abnormalities,and 28 cases of normal were diagnosed.Comparing to histology, sensitivity was 95.89% ,specificity 84.85% , positive predictive value 93.33% , negative predictive value of 90.32%.Conclusion Hysteroscopy combined pathology was the best method to diagnose postmenopausal uterus bleeding.